Provider Demographics
NPI:1568060622
Name:MCCALLION, DANIELLE DEBUSSEY (FNP-C)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:DEBUSSEY
Last Name:MCCALLION
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4225 EXECUTIVE SQ STE 450
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-8411
Mailing Address - Country:US
Mailing Address - Phone:858-810-8000
Mailing Address - Fax:858-268-1911
Practice Address - Street 1:4225 EXECUTIVE SQ STE 450
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-8411
Practice Address - Country:US
Practice Address - Phone:858-810-8000
Practice Address - Fax:858-268-1911
Is Sole Proprietor?:No
Enumeration Date:2020-10-12
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95015530363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily